Medical Resource Specialist

CoxHealth•Springfield, MO

9d•Onsite

About The Position

The Medical Resource Specialist (MRS) performs administrative duties supporting the Nurse Reviewer (NR) in the utilization process and other department procedures. The MRS acts as a liaison between Cox HealthPlans (CHP), providers, and members to help ensure requests are processed accurately and in a timely manner. The role promotes effective utilization of product lines in accordance with plan provisions and department guidelines while minimizing unfavorable expenditures. The Medical Department expects all staff to perform their duties accurately, promptly, and professionally.

Requirements

High school diploma or equivalent.
Excellent verbal and written communication skills.
Ability to work independently and collaboratively in teams.
Self-starter with high motivation and ability to manage multiple tasks and deadlines.
Fluency in typical office software, including Word, Excel, and PowerPoint.
Excellent typing skills.
Knowledge of basic medical terminology.
Strong phone skills.
Excellent organizational skills.

Nice To Haves

3–5 years of related experience.

Responsibilities

Perform administrative duties associated with services required by the Nurse Reviewer for the utilization process and other department procedures.
Serve as a liaison between Cox HealthPlans, providers, and members to help ensure requests are processed accurately and in a timely manner.
Promote effective utilization of product lines in accordance with plan provisions and department guidelines while minimizing unfavorable expenditures.
Carry out duties accurately, in a timely manner, and professionally.